Friends and family say Cpl. Adam Wolfel returned from the war in Afghanistan a changed man, a battle still raging in his mind.
He rarely slept.
When he did, he was often unrousable.
Awake, his moods fluctuated wildly, described as “hair trigger” and combustible.
To those around him Wolfel seemed increasingly tormented in the years after his deployment.
He seemed haunted.
The family’s St. Marys home is now something of a shrine to the U.S. Marine who on Dec. 13, at 23 years of age, took his own life there after a lengthy and largely private battle with Post Traumatic Stress Disorder (PTSD).
A 2013 Department of Veterans Affairs (VA) study estimated 22 U.S. veterans — the majority of them 50 years of age and older — were lost to suicide daily in 2010, with only 21 of 50 states reporting.
Other studies place the rate for younger veterans at closer to one per day. Variables including active duty status, pre-existing mental illness and previous suicide attempts all exist.
But despite some quarreling over root causes, much, if not all of the research agrees that U.S. veterans now face a far greater risk of suicide than their civilian counterparts.
Much would also agree that military suicides have outpaced or rivaled combat deaths in the two wars waged since Sept. 11, 2001.
The findings confirm what some in the veteran community have been saying for years: Invisible war wounds are real and claiming American lives by the thousands.
But only after decades of dismissal is their private struggle going public.
As a result, an issue long shrouded in military taboo and machismo is beginning to see the light of day, and a VA system best-equipped to treat tangible traumas is beginning to focus on the mind.
The public is newly receptive too, after decades of changing American attitudes towards war, soldiers and psychiatry in general.
But holes in the safety net remain, ones that have swallowed entire families like Wolfel’s overnight, leaving a generation of military veterans and their loved ones caught in the balance.
For them, the living casualties of wars in Iraq and Afghanistan, enlightenment around the issues of military suicide and PTSD offers little solace as they confront still fresh traumas and a lifetime of residual trauma that lay ahead.
For those individuals an invisible and largely solitary fight is now under way, one that will continue long after the drawdowns and homecomings are complete.
It will test the bonds of military service, the bounds of government infrastructure and America’s commitment to its men and women in uniform.
It will also injure and, inevitably for some, it will kill.
For those stuck fighting it, the war has come home and like all others it will be hell, its mark indelible.
For Adam Wolfel there was no turning back.
At a crossroads after high school and headed into a four-year technical college, he did an abrupt about-face, enlisting with the U.S. Marines amid ongoing wars in Iraq and Afghanistan. He followed two grandfathers and an uncle into the armed services.
“I often told Adam you chose to join the Marines, your father and I were drafted into it,” his mother Jane says.
She is seated in the living room of the family’s Beech Road home on a cold Sunday afternoon in February. It is the day after Adam would have turned 24 and the family has gathered to mark the occasion.
Outside, a Marine Corps flag waves stiffly atop a 30-foot pole planted in the front yard by Adam’s father Mike.
Inside, the space is populated with Adam’s service photos, accolades and patriotic miscellany.
Cartoons play softly on a big screen television for the benefit of Adam’s now 3-year-old son, the chipper program offering a stark contrast to the mood of the room.
“When he came back, I don’t know how to describe it, he was just on edge,” Mike said of his son, breaking the remaining silence.
“We immediately started seeing signs of PTSD ... A hair trigger could either make him angry, could make him just go silent or want to go be by himself.”
There were few answers for the family in those early days, the father explains, adding, “At first he wouldn’t talk to us about anything of course.”
That would eventually change.
Over time, Adam would slowly and painstakingly open up about his experiences abroad.
He would describe to family a harrowing year spent in Afghanistan’s Helmand Province at the height of now legendary blood-letting there. He would tell of being with the second wave of allied troops to hit the ground in the Battle for Marjah, the subject of a 2011 eponymous HBO documentary.
He told of being shot at by child snipers, of being pinned down in firefights with Taliban insurgents — once flat on his belly in an opium field, the bullets parting the pregnant flowers all around him. At least one enemy round is said to have landed inches from his face, shattering a rock and pelting his protective eyewear with gravel.
Speaking to his father, Adam would describe the adrenaline of war: The camaraderie, near constant scrapes with death, tattered sleep cycles and endless, jittery patrols.
To his mother he conveyed the emotion: The poverty he witnessed firsthand, the fear and isolation he felt, sometimes the death he touched.
Adam’s deployment to Afghanistan lasted roughly one year, a fairly standard-length tour of duty depending on position and military branch.
By all accounts, though, his was a particularly unrelenting stint.
With a fellow gunner sidelined, Adam would pick up a second shift of patrols through Taliban strongholds rife with shadowy enemies and rigged with roadside bombs.
As a result, his father says Adam saw more action than most in a relatively short amount of time.
His tour would include the deaths and injuries of colleagues, men like Ian Muller, a Vermont Marine whose body Wolfel reportedly helped drag from an Afghan battlefield so that it might be shipped back home.
Adam’s family believes he never fully recovered from incidents like these.
And while he sustained no serious physical injuries in combat, over time they began to notice deep and troubling changes in him, the signs, they say, of invisible wounds bleeding beneath the surface.
“He was triggered everywhere,” his sister Amanda recalls. “You wouldn’t even know it but sometimes we’d be doing something and somebody would say something, or he would hear something or see something and he would just immediately flip, like a light switch. His mood would just darken.”
His father chimes in, “You could see it in his facial expressions, even his eyes, it changed. It was definitely a Dr. Jekyll and Mr. Hyde-type thing.”
In describing Adam before the transformation, his parents visibly relax. They shift back in their seats and out from under a heavy, semi-permanent sense of exhaustion and grief.
He is remembered as a scrappy and outdoorsy child, a devoted Eagle Scout and later a devoted husband and father to his now toddler son.
The child was born as Adam fought abroad. His father Mike said during the delivery he received a call from a Marine commander embedded with Adam in the field. Mike recalls updating him on the birth and hearing gunfire in the background.
Looking back, he views it as proof of the Marine Corps brotherhood, as well as the devotion Adam inspired in those who knew him. He describes his son as fiercely loyal and a natural leader, someone who navigated youthful indiscretions to come out the other side wiser and more mature.
After leaving the war in 2011, Adam would continue with periodic deployments, this time to non-combat zones like Japan.
Once honorably discharged in 2013 he would return home to Elk County for good and dive into the role of provider for his young son.
To make ends meet Adam took a job at a local St. Marys electrical service company.
He would later begin classes at the same Williamsport technical college he passed on years earlier for a shot at the service.
Adam would also begin psychotherapy with a Williamsport-area VA doctor at the urging of his family.
But despite all of his progress, his demons proved inescapable.
Adam separated from his wife, grew increasingly mercurial and on a cold and wet Saturday in December ended his life.
His parents and psychologist believe Adam suffered a mood swing or war-related flashback on the night of his death. It is said he vomited right beforehand and that an autopsy revealed no other likely cause.
Doctors also believe it was impromptu: He had no prior suicide attempts to his parents’ knowledge and on the day of his death appeared normal, “maybe a little agitated” his mother recalls.
She said Adam had been out that evening at a party and apparently enjoying himself. She remembers congratulating him beforehand on having completed 20 percent of his college degree.
Now she’s left to wonder, “Could I have done more?”
In Erie, near the shores of the namesake Great Lake, VA Medical Center officials say a tide of troubled veterans there continues to rise, the peak ostensibly nowhere in sight.
As much as one-third of the center’s patients were diagnosed with PTSD as of 2014, a clinical psychologist there estimated. Nationwide, another 30 percent of U.S. veterans having served in Iraq or Afghanistan are said to suffer with the condition triggered by a terrifying event and manifesting as flashbacks, nightmares and severe anxiety. An estimated 250,000 PTSD diagnoses have been made by VA doctors since 2001.
The numbers have grown with the wind-downs of two wars on terror and the increased willingness of veterans to admit to and seek help for psychic pain.
But many more go unnoticed entirely.
It is a point often made by families of service members in criticizing military outreach efforts as lackluster and top officials as indifferent to the crisis building all around them.
A lack of continuing guidance in the transition back to civilian life is also cited as a primary reason so many troops, roughly 10 percent of those diagnosed with conditions like PTSD or depression, fail to stick with treatment.
According to spokespeople, the VA is not provided with a list of returning soldiers’ names and is only aware of those who voluntarily enroll in its care. A soldier or Marine’s transition from active to non-active duty is left to the Department of Defense, which conducts “separation counseling” and planning prior to a troop returning home.
Beyond that, much is left to the individual.
“There are no clear lines in going from active duty to getting out of the service to coming in for VA care,” Erie VA spokesperson Sarah Gudgeon said. “While we conduct plenty of outreach, it’s ultimately up to the veteran, they have the right to accept or decline care.”
For Eric Brown, an Iraq war veteran whose return to northwest Pennsylvania brought with it a first-time PTSD diagnosis, the issues facing soldiers at home are myriad, often compounding already difficult transitions.
“You’re kind of lost,” Brown said. “(In the service) you don’t have to worry about housing, housing is provided, meals are provided. Coming out and having to pay gas, electric, water, look for places to stay and just having all these bills — it was kind of overwhelming.”
As a result, the joys of homecoming can be short lived, he said.
For Brown, the process meant bouts of anxiety and anger, all while pin-balling from dead end job-to-dead end job and struggling to come to grips with the grim, lingering realities of war.
“You’re forced to deal with things you’ve seen, you’re forced to deal with things you may have done,” he said. “You look back and your buddy to the left or right of you might have died right next to you. You’re putting all these burdens on someone’s shoulders and sometimes it just feels like it’s unbearable.”
A rapid decompression followed his release from the strictures of military service and the move home brought with it a strange and, for Brown, unsettling lull after years of living under the gun.
“Everywhere is front lines in Iraq,” he said.
“It can happen anywhere over there. For myself, I can’t speak of how many times our base was attacked over there. It was pretty much every day. I think there was one day where there was no report of incoming mortar, rocket, or small arms fire.”
He added, “And that was just what we experienced on base. That doesn’t include what is encountered outside the wire like raids or patrols.”
Back in Erie, acts of real aggression gave way to the passive aggression and petty problems of everyday life at home.
Brown recalls having trouble adjusting.
“I had a few people point out to me, ‘You’re different,’ or ‘Why are you so angry?’”
He would attempt to find out, eventually entering treatment with the Erie VA in a move he credits with both turning his life around and helping to find his post-war purpose as a VA peer specialist.
Through the role, Brown guides fellow veterans into treatment and through similar struggles to his own. He operates not as a clinician but as someone who’s been there himself.
But while Brown’s is a remarkable, even fortuitous outcome, others will not be so lucky.
In attempting to catch those who fall through the cracks, Gudgeon said the VA conducts mental health outreaches with community partners and mans 24-hour support hotlines.
Trigger-locks are also offered to veterans and their families, free of charge, to better supervise the lethal options, like firearms, at their disposal. The Erie VA medical center reports distributing more than 10,200 of the locks by mail and “countless others” through the roughly one-year-old program. The center’s catchment area includes more than 22,400 veterans in McKean County, Elk County and the surrounding region.
Those who do decide to enroll in VA care submit to a battery of tests including screenings for traumatic brain injuries — theoretically linked to compulsiveness, mood disorders and suicide — as well as other adjustment related issues, PTSD and suicidal thoughts.
Special attention is paid to combat veterans like Brown and Adam Wolfel who, according to Lisa Schwartz, a suicide prevention coordinator at the Erie VA, present the highest risk.
She attributes this to “the things they see on these deployments including multi-casualty incidents, the aftermath of battle, having to handle human remains, the death of a leader, close friend or battle buddies and also debilitating injuries.”
In treating the result, the VA says it has enlisted a veritable army of psychologists, psychiatrists, counselors and peer support specialists, part of what the organization describes as a huge mental health push. Medications are made available as well.
Behind the scenes, broader efforts are under way to determine the underlying genetic and environmental components of these conditions and elevated risks.
But there, the real work has only just begun.
There is much that isn’t known about the human brain, what some call the final frontier of human physiology.
Even less is known about how the brain works and evolves under extreme and prolonged stress.
Studies are under way to better determine the links between war, arguably the greatest stressor of all, and profound neurological changes in the men and women who wage it.
But while the research is burgeoning, the phenomena is far from new.
Although more recognizable now and reaching modern highs following two wars on terror, the psychological toll of war is documented as far back as Homer’s “Iliad.”
In World War I, the term “shell shocked” referenced clinical combat stress reactions, including night terrors and tremors. The condition was linked by some to the war’s extended use of bombardments and to soldiers’ repeated exposure to high-powered blasts that jarred their brains and rattled their psyches. To this day, studies continue to determine the relationship between blast injuries and long-term cognitive disruptions, the work spurred on by the widespread use of improvised explosives, or roadside bombs, in Iraq and Afghanistan.
In World War II, the term “battle fatigue” described soldiers suffering mental exhaustion, depression and paranoia sown by combat trauma.
But while the terminology has again evolved, this time to the current Post Traumatic Stress Disorder or “PTSD” label, the stigma attached has never wavered.
Generations of service members have cited entrenched resistance to psychiatric claims from supervisors skeptical of their motives or who dismiss them as indicative of a lack of spinal fortitude.
“As far as the Army is concerned, it’s suck it up and drive on,” said Eric Brown, the VA peer specialist in Erie.
“You’re a veteran, a soldier, a Marine and you should be better than that, you should be stronger than that, you should be able to kind of deal with this stuff on your own.”
In St. Marys, Mike Wolfel said his son was similarly indoctrinated.
“It was ingrained in him not to seek help,” he added.
But Adam eventually did, enrolling in treatment at a Williamsport-area VA hospital after returning to college there, the campus a roughly three hour drive from his parents’ home.
His doctor — who is revered by the family and who has stayed in regular contact, even calling on what would have been Adam’s 24th birthday — often cited the vulnerability of young brains like his, saying they’re still growing when the military helmet goes on.
“The brain is still developing at 25 or 26 years of age,” Mike Wolfel quoted the doctor as saying, pointing out that Adam turned 20 while serving in Afghanistan. “And when you put it through that much stress it can really get permanently broken.”
At the time of his death, Adam was preparing to undergo an intense psycho-therapy regimen consisting of reliving and confronting past traumas.
“He was nervous about it though,” his father said of the plan. “He was going to hash out each and every event until he came to terms with it hopefully.”
He pauses. “But that didn’t happen — obviously.”
It is a frigid December morning in St. Marys and a slow trickle of mourners grows to a torrent on the streets around the city’s Sacred Heart Church.
Inside Adam Wolfel’s funeral has drawn hundreds braving the cold.
Attendees pack the nave of the church and an upstairs balcony.
They crowd around gothic-arched doorways and into hallways, nearly spilling over onto the sidewalk outside.
Among them is the father of Ian Muller, the Marine whose body Wolfel helped recover from the battlefield in Afghanistan.
The man says he came to show his appreciation and to pay his respects.
He is joined by Marines and service members from Maine, Nevada, Florida, Alabama and beyond.
Wolfel’s family says others planned on attending but were instead redeployed first.
Most of those in attendance are known to Wolfel’s parents, many on a first-name basis.
Mike and Jane routinely monitor the lives of Marines who served with their son, as well as some who didn’t. They know who was recently fired from their job. Who has fallen off the grid. Whose parents haven’t heard from them and for how long.
The couple scours social media pages for warning signs, ready to spring into action at the slightest hint of trouble.
It is this interventionist spirit that prompts Mike Wolfel to address the crowd at his son’s service.
He has nothing prepared, a fact he apologizes for in advance.
After saying a few words about Adam, he asks the service members present to stand.
They do, rising in their uniforms and near perfect unison, dispersed throughout the pews in tight groupings. They stay standing as Wolfel tells them he fears for their lives and refuses to lose another like he did his son.
“This is contagious,” he adds.
He implores the men to stay in touch with each other or with him, let the military family serve its supporting role.
It is a candid moment played out in public and the members of the audience still seated are rapt, glimpsing the inner workings of a fraternity like no other.
“Part of being a man is asking for help,” Wolfel says with a paternal flourish before telling the men to sit back down. They do so silently.
After the service they all follow Adam’s coffin as it is led from the church.
Outside a 21-gun salute shatters the winter air. The casket is then placed into a waiting hearse. The American flag covering it is removed, folded into a triangle and handed to Adam’s son.
Inside the coffin, a tattoo on Adam’s arm includes a passage from Ernest Hemingway’s Act of Valor. It reads: “When it comes your time to die, be not like those whose hearts are filled with fear of death, so that when their time comes they weep and pray for a little more time to live their lives over again in a different way. Sing your death song and die like a hero going home.”
The artwork also depicts a belt of high caliber bullets wrapped around the names of three fellow Marines killed in action.
As for suicides, Adam’s was the fourth from his Company alone, his father reports.
In one battalion, eight members were lost to fighting abroad while 16 were lost to suicide at home.
“That doesn’t make sense,” Mike Wolfel says. “How do you have twice the number of suicides as combat deaths?”
It is a question often posed by the Wolfels as they advocate for increased awareness around deaths like their son’s and what is, by all accounts, an epidemic of suicide plaguing the American armed forces.
“Stop the 22,” a reference to the VA study listing as many as 22 veteran suicides each day in this country, greets visitors of Mike Wolfel’s Facebook page and has become a rallying cry for the family.
Following his speech at the church, Mike says three Marines reached out to him for help.
Mike says he “talked them down,” something his son had also done for fellow service members prior to his death.
In the year leading up to Adam’s suicide, his family says he expressed a desire to go back to war after watching Islamic State militants undo U.S. gains in Iraq with break-neck speed.
Mike believes Adam would have likely stayed in the service and joined the special forces.
“He said ‘That’s where I feel at home. I know what my purpose is,’” Mike recalls inside the family’s living room on the cold Sunday afternoon in February.
He says his son appeared “lost” as a civilian.
Adam’s mother Jane agrees and becomes emotional in considering that her son was both fatally burdened and innately fulfilled by military service.
“What the hell do these kids have to go through? As a mother it makes me very angry and it’s like, ‘Why didn’t I see something or do something. I could have stopped his pain,” she says, choking back tears.
Jane, wearing a hoodie emblazoned with the Marine Corps seal, is seated beside her husband on the couch.
A photo of Adam is nestled between them, watching his sister and son as they play across the room, the cartoons on the television now all but forgotten.
“You hear time heals all wounds, I think that’s B.S.,” Mike said, referring to invisible wounds like those once suffered by his son.
“They’ll lessen over time and maybe over time they’ll find more civilized ways of coping, but they’re always going to have these wounds.”
He pauses. “My heart bleeds for these kids.”